ABSTRACT
Objetivos: Exponer los resultados de la implantación de un cribado ecográfico "semiuniversal" para el diagnóstico precoz de la displasia de desarrollo de la cadera (DDC) que incluye a todas las niñas y a los varones con factor de riesgo. Material y método: De los 16.943 recién nacidos en nuestro hospital en 4 años, se estudiaron por ecografía 8.596 (7.892 niñas y 744 varones). El cribado se realizó a las 5 semanas de vida e incluyó seguimiento de las caderas con inmadurez fisiológica. Resultados: Se detectaron 76 niños con DDC resultando una incidencia del 4,4 por mil. La edad media de detección fue de 1,4 meses y la duración media de los tratamientos 3 meses. Se consiguieron bajos índices de displasias tardías (0,2 por mil) y de cirugía (0,3 por mil). Todos los niños curaron sin secuelas. Conclusión: Consideramos al cribado semiuniversal una opción válida al cribado universal, con resultados similares y menor coste
Objective: The purpose of this article is to describe the findings of our semiuniversal ultrasound screening for the early diagnosis of developmental dysplasia of the hip (DDH) including all newborn females and males with risk factors. Materials and methods: 8596 newborn (7852 females and 744 males) underwent sonography from a total of 16943 newborn in our hospital over a four year period. The screening ultrasound was performed when the infant was five weeks old and included follow-up of the hips with physiological immaturity. Results: 76 infants with hip dysplasia were detected with a resulting incidence of 4.4 per thousand. Mean age at diagnosis was of 1.4months and the mean length of treatment was of 3 months. With this strategy low rates of late dysplasias (0.2 per thousand) and surgical treatment (0.3 per thousand) were achieved All infants recovered without secuelae. Conclusion: We consider the semiuniversal screening to represent a valid alternative to the universal screening, with similar results and reduced costs
Subject(s)
Male , Female , Infant, Newborn , Humans , Hip Dislocation, Congenital , Hip Dislocation, Congenital/therapy , Neonatal Screening/methods , Treatment Outcome , Follow-Up Studies , Risk Factors , SpainABSTRACT
Abdominal ultrasonographic study is a part of the acute abdominal pain diagnosis protocol in our hospital. As an internal quality assessment, we performed a six-month prospective study, including those patients who meet one of these requirements: 1st the reason for attendance being non-traumatic abdominal pain 2nd an abdominal ultrasonography achieved at the hospital. Collected data included: demographic characteristics, presenting sign and symptoms, test results, ultrasonography, final diagnosis and treatment. Children attended to the hospital were evaluated through clinical findings to verify concordance between clinical and ultrasound diagnosis, and patients who did not stay at the hospital had telephone follow-up in 2 weeks. A total of 136 patients underwent ultrasonography (7 children did not cooperate and were discarded): 74 females and 55 males with a mean age of 9.52 years. Admission was required in 63 subjects and 66 were sent home after clinical evaluation. Abdominal ultrasonography was performed by the radiologist on duty (occasionally paediatric radiologist). Ultrasound examination, for acute appendicitis, had a sensitivity of 94.8%, specificity of 98.8%, positive predictive value of 97.3% and negative predictive value of 97.8%. Abdominal ultrasonography has showed usefulness for surgical pathology discrimination in acute abdominal pain. When ultrasonography is inconclusive, clinical follow-up and periodical ultrasonography results in a positive change in management and treatment.
